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Dental Provider File Submission

Maine

Versions: Dental Provider File Submission• Dental Provider File SubmissionCompare Versions


Name:Dental Provider File Submission
State:Maine
Definition:Not Provided
Versionv1.2

File Specification for Dental Provider File Submission

Data Element ID Data Element Description Type Format Length
Multiple versionsDCPM901 Data Processing Center Provider Code This field contains the unique provider identifier that crosses all payers. This field is the link to the Dental Services Provider file (DCSP001). NUMBER 12
Multiple versionsDCPM902 Service Provider Tax ID Number This field should contain the provider's tax identification number. For an individual this code is often the social security number. This field is derived from DC026 in the dental claims data. CHAR 10
Multiple versionsDCPM903 Service Provider Facility Name This field contains the normalized first name of the practitioner. If the provider is a facility, this field will be blank. This field is derived from DC024 in the dental claims data. CHAR 60
Multiple versionsDCPM904 Service Provider Facility Code This field is reserved for future use. CHAR 10
Multiple versionsDCPM905 Service Provider First Name This field contains the normalized first name of the practitioner. If the provider is a facility, this field will be blank. This field is derived from DC022 in the dental claims data. CHAR 25
Multiple versionsDCPM906 Service Provider Middle Name This field contains the normalized middle name or Initial or initial of the practitioner. This field is derived from DC023 in the dental claims data. CHAR 25
Multiple versionsDCPM907 Service Provider Last Name This field contains the normalized full name of individual practitioner. This field is derived from DC024 in the dental claims data. CHAR 60
Multiple versionsDCPM908 Service Provider Suffix This field contains the normalized generational suffix for the individual. This field is derived from DC025 in the dental claims data. CHAR 10
Multiple versionsDCPM909 Service Provider Title Not Provided CHAR 10
Multiple versionsDCPM910 Service Provider State or Province This is the normalized two character abbreviation for city as defined by the US Postal Service. This field is derived from DC028 in the dental claims data. CHAR 2
Multiple versionsDCPM911 Taxonomy Code This field is used to standardize the specialty coding of the provider records. It is based upon the service provider specialty code (DC026) and the linkage activity. A single DPCID will have only one national TAXONOMY code. CHAR 10
DCPM912 National Provider Identifier This field contains the National Provider ID as established under HIPAA. This field is derived from DC020. CHAR 20

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Data Element ID Data Element Code Value
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